FP461EFFECTS OF HEMOPERFUSION ON PROTEIN-BOUND UREMIC TOXIN CLEARANCE AND THE QUALITY OF LIFE IN MAINTENANCE HEMODIALYSIS PATIENTS

Abstract

Introduction and Aims:Objective:To observe the effects of hemoperfusion(HP) on the clearance of protein‐bound uremic toxins, middle and large‐molecule uremic toxins and quality of life in maintenance hemodialysis patients(MHD). Methods: Methods: 36MHD patients were randomly divided into two equal‐size groups. hemodialysis (HD) group were treated with low‐flux hemodialysisthree times a week; HD+HP group were treated with regular low‐flux hemodialysis twice a week and the combination of hemodialysis with hemoperfusion once a week. The follow‐up period was 36 weeks. Serum calcium, phosphorus, intact parathyroid hormone (iPTH), serum albumin, hemoglobin, ferritin, transferrin saturation,b2‐microglobulin (b2‐MG),hippu‐ric acid (HA),indoxylsulphate(IS), p‐cresylsulphate (PCS),the dialysis adequacy Kt/V and Blood pressure were compared before and after the study,the Kidney Disease Quality of Life Short Form(KDQOL‐SF1.3) scale was used to assess the quality of life. Results: Result: 1.The concentration of protein bound uremic toxins,including HA and PCS, and the middle and large‐molecule uremictoxin b2‐MG,were compared before and after study.HD group showed no statistical difference (p>0.05) for all three toxins (HA:p=0.747; PCS:p=0.861; b2‐MG: p=0.236). However, their concentrations in HD+HP group were significantly decreased (p<0.05) after the 36‐week treatment(HA: p=0.040;PCS:p=0.041; b2‐MG: p<0.001). Atthe endof the study, The HD+HP group was significantly lower than the HD group for all three toxins (HA: p=0.045; PCS: p=0.048; b2‐MG: p=0.015).2.The concentration of protein bound uremic toxin IS was significantly higher (p=0.035)in the HD group after the 36‐week treatment, and there was no statistical difference in HD+HP group (p=0.332). There was no significant difference between the two groupsat the end of the study (p=0.137). 3 In the comparison qual‐ity of life, the two measured parameters, bodily pain and vitality score were significantly lower after treatment, compared to the baseline in HD group, with p‐values of 0.049 and 0.009, respectin‐vely. In HD+HP group, the dialysis related symptoms, effect ofkidney diseaseand vitality score increased significantly compared tothe baseline, with p‐values of 0.032,0.025 and0.034, respectively.The effects of kidney disease, cognitive function, sleep, physical function, bodily pain, general health, social function andvitality were significantly better in HD + HP group than inHD group(p‐values of 0.043, 0.049, 0.047, 0.032, 0.042, 0.024, 0.043 and 0.015, respectively). Conclusions: Conclusion:Long‐term useof HD+HPin the removalofprotein‐bound uremic toxins and middle and large‐molecule uremic toxins in MHD patient‐swas significantly better than conventional HD, while significantly improved the quality of life.